Impact of Virtual Reality Headset on Pain and Anxiety for Bedside Abdominal VAC Dressing Change (VIRPA): A Randomized...

Virtual reality (VR) distraction techniques are promising adjuncts to reduce pain and anxiety. This study assessed the impact of VR distraction during bedside change of vacuum assisted closure (VAC) dressings.

In this non-blinded randomized superiority trial, patients scheduled for bedside change of a subcutaneous VAC dressing were allocated to receive distraction through VR masks in addition to a standardized pain protocol (intervention) or pain protocol alone (control). Primary endpoints were pain scores assessed by a visual analogue scale (VAS: 0-10), secondary outcomes were anxiety (State Trait Anxiety Inventory (STAI), VAS: 0-10), hemodynamic parameters, and satisfaction (VAS: 0-10).

Pre- and postoperative pain levels were 2.2 ± 2.2 versus 2.0 ± 2.1 (p = 0.38) for the intervention group (21 patients) compared with 2.6 ± 2.1 versus 2.2 ± 1.6 (p = 0.26) for the control group (19 patients), with no significant difference between the groups (p = 0.38). No differences between the two groups were observed for blood pressure and heart rate (HR), besides lower post-procedural HR in the intervention group. Anxiety was reduced in both groups post VAC change in the intervention and control group: STAI 40 ± 12 pre-VAC versus 30 ± 8 post VAC and 45 ± 14 pre-VAC versus 32 ± 9 post VAC (both p < 0.01), ∆VAS -2 (interquartile range IQR 0, -3) versus -2 (IQR 0, -5), both p < 0.01. Postinterventional satisfaction was 8.3 ± 1.9 (intervention) versus 7.5 ± 2.4 (p = 0.11).

Pain and anxiety were well managed within a standardized pain protocol, with or without adjunct VR distraction. While this may be due to limited statistical power in this exploratory pilot study, further studies should focus on patients with insufficient control of pain and anxiety with a standard protocol to assess the additional value of VR distraction. Trial Registration: study registered in the FOPH portal SNCTP (Swiss National Clinical Trial): NCT04472416.